ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1614782
Oral low dose of glutamine improved the spontaneous closure in patients with external duodenal fistula: A retrospective comparative study with propensity score matching
Provisionally accepted
- Nanjing Jiangning Hospital, Nanjing, China
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Spontaneous closure of external duodenal fistula (EDF) is associated with reduced gastrointestinal inflammation. Low-dose glutamine supplementation in the intestine can directly improve intestinal permeability and promote mucosal healing, potentially aiding fistula closure. This study investigates the effects of oral glutamine supplementation on EDF treatment outcomes.A retrospective cohort study was conducted from January 2019 to June 2024, including 104 adult patients with EDF. Based on the administration of low-dose (10g/day) oral glutamine supplementation, patients were divided into a glutamine group (n=54) and a non-glutamine group (n=50), with 46 matched pairs after propensity score matching (PSM). The outcomes were spontaneous fistula closure, mucosal healing, and hospital stay duration.Spontaneous closure occurred in 28 patients (52%) in the glutamine group, compared to 21 patients (42%) in the non-glutamine group (P=0.04). Glutamine promoted fistula closure both before (HR = 1.82; 95% CI: 1.03-3.23, P=0.04) and after PSM (HR = 1.94; 95% CI: 1.07-3.53, P=0.03). The median hospital stay was shorter in the glutamine group, both before (65 days days] vs. 106 days [IQR: 56-119 days], P=0.01) and after PSM (76 days [IQR: 32-122 days] vs. 110 days [IQR: 54-122 days], P=0.02).Glutamine supplementation may enhance spontaneous EDF closure and reduce hospital stay duration.
Keywords: Glutamine, Fistula, Spontaneous closure, outcomes, Length of Stay
Received: 19 Apr 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Huang, Luo, Yao, Xu, Zhao, Zhao and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zheng Yao, Nanjing Jiangning Hospital, Nanjing, China
Risheng Zhao, Nanjing Jiangning Hospital, Nanjing, China
Tianchi Yu, Nanjing Jiangning Hospital, Nanjing, China
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